Training patients to cannulation with buttonhole needles

Ask Our Experts Stuart Mott, Cannulation Expert
1

I am a fairly new home therapy nurse and I have 6 NxStage patients to date that I have trained. I am amazed at the results I have had using the touch cannulation technique. After considerable difficulty penetrating the vessel with my attempts at buttonhole cannulation, I researched buttonhole technique on-line and luckily found your webinar on this method. Realizing the vessel flap is not an actual part of the track was profound for me. Before, I would simply give up and use sharp needles with stubborn cannulations. Now, thanks to your webinar, I know not to do that. I have been able to sucessfully train 3 new NxStage patients using this method and two of them self cannulate. Getting right over the vessel flap can be tricky and somewhat frustrating for the patient. I have two questions. I have seen a gel used to lubricate the vessel track in some of the info on-line. Do you think this would help? Does it get easier as time goes by to open the vessel flap as there access is repeatedly cannulated?

2

Thank you for your comments. You have graduated to becoming a master cannulater. If you go to the Fistula First website (http://www.fistulafirst.org Section 8, you will also see the written article on this. Section 13 is on teaching patient how to self cannulate. We have 13 who currently self cannulated in our clinic. It gives control back to the patient and they feel like they are taking an active part in their dialysis. All of them are are taught self cannulation if they can, and after the first 6 to 8 treatments, we leave it up to them if they want to continue. But one thing that is an A+ for them is that they know how deep and where their accesses go, so if you have multiple cannulators, you have less infiltration.

  1. I personal have no knowledge of this cream, but I’m always looking for new things to help with cannulation.

  2. Yes it does get easier as time goes on but not for everyone, because of the size of the vessel they are cannulating. Some patients have thicker vessel walls than others, and they differ by age, work, etc. So, those patients may have to stay with a sharp needle, but they are the only ones who can cannulate themselves and they have to use “touch cannulation.”

Call if you need more info 1-573-592-0117 Stuart